Hundreds of thousands of type 2 diabetics should be offered weight loss surgery to cure diabetes, world experts claimed today.

They say the world is in the grip of a ‘pandemic’ and that drugs and lifestyle interventions alone will not solve the crisis.

Instead, the joint statement by 46 leading international organisations calls for gastric bypass operations to be offered as routinely as hip and knee replacements.

One reason it is thought to work so well is that patients eat less and the subsequent reduction in weight and calorie consumption causes their blood sugar levels to fall.

In addition, researchers believe the surgery triggers important changes in the bacteria of the gut which also lowers the blood sugar.

The experts said the advice constituted one of the biggest shifts in diabetes treatment guidelines since the advent of insulin - and could have a significant benefit for thousands of patients.

The world is in the grip of a diabetics ‘pandemic’ that drugs and lifestyle interventions alone will not solve

The group said bariatric, or metabolic, surgery could have a significant benefit for patients with the disease.

Francesco Rubin, a professor and chair of metabolic and bariatric surgery at King's College London - and one of the authors of the new guidelines - said many countries across the world are in the midst of 'an epidemic of diabetes'.

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While surgery would not be suitable for all, and should not be seen as a silver bullet solution for the global diabetes problem, he said patients should be offered a range of options - including lifestyle changes, medications and surgery.

WHAT DOES SURGERY INVOLVE?

Type 2 diabetes is trigged by obesity and a lack of exercise and occurs when either the body doesn’t produce enough insulin to regulate the blood sugar, or the cells don’t react to it.

This causes them to have high blood sugar which can lead to serious and fatal complications including kidney failure, strokes, blindness and damage to the feet leading to amputations.

But results from ongoing trials show that weight loss surgery is at least three times as effective at helping patients control the blood sugar than medication or diet alone.

One reason it is thought to work so well is that patients eat less and the subsequent reduction in weight and calorie consumption causes their blood sugar levels to fall.

In addition, researchers believe the surgery triggers important changes in the bacteria of the gut which also lowers the blood sugar.

They say gastric bypass is the most effective operation whereby the stomach is divided up into a smaller pouch, meaning patients cannot eat as much.

The other common procedure is a gastric band – when a silicone device is placed above the stomach – but this works less well and needs to be replaced.

Many patients can manage their diabetes with medication and diet, but the disease is often life-long and is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

A recent World Health Organisation study found the number of adults with diabetes has quadrupled in the past four decades to 422 million.

And the international Diabetes Federation (IDF) estimates that by 2040 this will rise to 642 million.

The new guidelines say surgery designed to reduce the stomach and induce weight loss should be recommended to treat all diabetes patients whose body mass index (BMI) is 40 or over.

This is regardless of their blood glucose control, as well as those with a BMI of 30 and over whose blood sugar levels are not being controlled by lifestyle changes or medications.

The guidelines, published in the journal Diabetes Care, were endorsed by 45 international organisations, diabetes specialists and researchers, including the IDF, the American Diabetes Association, the Chinese Diabetes Society and Diabetes India.

Obesity surgery involves the removal of part of the stomach or the re-routing of the small intestine in a bypass operation.

The guidelines are based on a substantial body of evidence, including 11 randomised trials, showing that in most cases surgery can lead to reductions in blood glucose levels below the Type 2 diabetes diagnosis threshold or to a substantial improvement in blood glucose levels.

In many cases this would lead to patients being able to give up or significantly reduce their diabetes medications.

How the move would affect Britons and the NHS

Today’s joint statement calls for the surgery to be routinely included as a ‘treatment option’ alongside drugs such as metformin, insulin, and diet and exercise programmes.

Currently the NHS only performs around 6,000 weight loss operations a year and the majority are for very obese patients rather than those with diabetes.

Professor Francesco Rubino, an expert in weight loss surgery who is also based at Kings College Hospital said: ‘We’re not advocating that we should operate on all the patients who could potentially be counted.

He went on to say weight loss or ‘bariatric surgery’ was not unaffordable for the NHS and pointed out that major knee replacements were three times more expensive.

The operations cost around £6,000 so the NHS would have to spend £60 million treating all eligible patients

Around 3.5 million Britons now have diabetes and the rates have soared by 60 per cent in a decade, largely due to obesity.

Of these, approximately 1 million are also obese and could potentially benefit from weight loss surgery.

The majority don’t need it however as they are managing well on drugs or lifestyle changes but researchers have identified 100,000 patients who could benefit immediately.

The operations cost around £6,000 a time so the NHS would have to spend £60 million treating all eligible patients.

We have a diabetes pandemic on our hands. We need new treatments. This is a real treatment for diabetes

But researchers say they would ultimately save money as the health service already spends £11 billion a year treating type 2 diabetes and all the associated complications.

They also claim it reverses the illness and trials have shown that up to half of all patients are effectively cured, and no longer have to take any drugs.

But the NHS is facing its worst financial crisis in a generation and figures last week showed that the black hole in its budget had trebled in a year to £2.45 billion.

Campaigners said it was a farce for doctors to offer costly surgery for obese diabetes when thousands of patients are being denied cancer drugs, hip replacements and cataract surgery.

But the statement by researchers from Kings College London, Diabetes UK and the International Diabetes Federation, amongst other organisations, calls for the NHS should stop taking a ‘punitive’ attitude to patients.

Professor Sir George Alberti, a world-renowned expert in diabetes from Kings College Hospital said: ‘We have a pandemic on our hands.

'We need new treatments. This is a real treatment for diabetes.

‘Its very easy to take a punitive approach. People have a punative approach to obese and say its their own fault and they don’t deserve help.

The more severe of my colleagues would say you just need to diet and exercise and it goes away.

But getting patients to do that over a long period of time is almost impossible.